Issue link: https://www.ascpskindeepdigital.com/i/1489006
54 ASCP Skin Deep Winter 2023 acne can be painful and emotionally fraught, but this specific treatment can have severe consequences with pregnant clients. "Usually if it's something you buy over the counter, the potency won't be a problem. But I would not prescribe a retinoid to someone who's pregnant." While there aren't a lot of conclusive studies about the safety of retinoids in pregnancy due to ethical concerns, the studies we do have indicate it is best to avoid retinoids during pregnancy. According to 2016 research published in the Journal of Aesthetic Nursing, "Birth defects and ear, cerebral, and cardiac malformations associated with retinoid embryopathy have been linked with the use of topical tretinoin . . . Tazarotene is also classified as a significant risk during pregnancy, as retinoid-like malformations in animal testing have been reported." 7 Also in the "don't use at all" category is hydroquinone, a skin-bleaching agent that has shown to be effective against hyperpigmentation. While there seems to be a low indication of risk, it's important to note that 35–45 percent of hydroquinone is absorbed systemically when applied topically. 8 So, it's best to avoid this ingredient during pregnancy. Trampetti says hydroquinone also has the potential to be a carcinogen, so she doesn't recommend it for her clients. She also cautions against the use of essential oils, as they may mimic hormones in the body, increase blood flow, and disrupt the endocrine system. Ones to specifically avoid include clary sage, fennel, and cinnamon. The "ask your doctor" category includes ingredients that are assumed to be safe at certain concentrations, but are best to have confirmed with a client's medical professional before use in a treatment or skin care regimen. Ingredients such as BHAs at or under 2 percent, AHAs at or under 10 percent, and chemical sunscreens are likely safe but can potentially cause sensitivity or inflammation. The research around BHA and AHA use during pregnancy is rather contradictory, but a 2017 study published in the International Journal of Pregnancy & Child Birth supplies a more in-depth look into the uses and indications: "Salicylic acid is classified as a Category C drug for pregnancy according to the aforementioned FDA guidelines, thus, its use during pregnancy is acceptable depending on specific patient factors." The study goes on to say glycolic acid could